To review the effectiveness of the available embolic materials used for portal vein embolization (PVE) on liver hypertrophy as well as their technical handling and safety profile, and to illustrate it with cases of our institution.

The myth of Prometheus - eagles feeding at his exposed liver - indicates that the ancient Greeks knew about liver's potential for repair1. Indeed, preservation of an adequate future liver remnant (FLR) so as to diminish postoperative morbidity and mortality2is one of the principal challenges in contemporary liver cancer surgery3. Furthermore, the FLR volume and function after surgery is directly associated with rates of complications and mortality after liver resections4, 5. In order to increase the FLR volume pre-operative portal vein embolization is performed and...

PVE technical aspects The first moment is to obtaining access to the portal venous system in which the contralateral or the ipsilateral approach is generally adopted. Regarding the type of the transhepatic approach, it is elected at the discretion of the operator and influenced by several factors such as the tumor burden in the non-FLR, the embolic agent chosen, the interventionist’s level of experience, the patient’s habitus and the extent of the embolization. The ipsilateral approach In the ipsilateral option access to the portal system...

Conclusions Even though there are suitable reports addressing different types of embolic materials their head-to-head comparison is not always possible due to PVE indications established on different measurement models, variances in the waiting period for hypertrophy after PVE (2–8 weeks), discrepancies in CT volumetry techniques, and differences in regeneration rates between cirrhotic, post-chemotherapy, and normal livers. Van Lienden et al.18 published a comprehensive review, which addressed many aspects of PVE. They compared the FRL volume increase achieved with different embolic agents, of which NBCA had...

1. Chen, T. S.; Chen, P. S., The myth of Prometheus and the liver. J R Soc Med 1994, 87 (12), 754-5. 2. Schindl, M. J.; Redhead, D. N.; Fearon, K. C.; Garden, O. J.; Wigmore, S. J.; (eLISTER), E. L. S. a. T. E. R. G., The value of residual liver volume as a predictor of hepatic dysfunction and infection after major liver resection. Gut 2005, 54 (2), 289-96. 3. Pamecha, V.; Glantzounis, G.; Davies, N.; Fusai, G.; Sharma, D.; Davidson, B., Long-term survival...